How robust is the evidence of an emerging or increasing female excess in physical morbidity between childhood and adolescence? Results of a systematic literature review and meta-analyses

Abstract

For asthma and psychological morbidity, it is well established that higher prevalence among males in childhood is replaced by higher prevalence among females by adolescence. This review investigates whether there is evidence for a similar emerging female ‘excess’ in relation to a broad range of physical morbidity measures. Establishing whether this pattern is generalised or health outcome-specific will further understandings of the aetiology of gender differences in health. Databases (Medline; Embase; CINAHL; PsycINFO; ERIC) were searched for English language studies (published 1992–2010) presenting physical morbidity prevalence data for males and females, for at least two age-bands within the age-range 4–17 years. A three-stage screening process (initial sifting; detailed inspection; extraction of full papers), was followed by study quality appraisals. Of 11 245 identified studies, 41 met the inclusion criteria. Most (n = 31) presented self-report survey data (five longitudinal, 26 cross-sectional); 10 presented routinely collected data (GP/hospital statistics). Extracted data, supplemented by additional data obtained from authors of the included studies, were used to calculate odds ratios of a female excess, or female:male incident rate ratios as appropriate. To test whether these changed with age, the values were logged and regressed on age in random effects meta-regressions. These showed strongest evidence of an emerging/increasing female excess for self-reported measures of headache, abdominal pain, tiredness, migraine and self-assessed health. Type 1 diabetes and epilepsy, based on routinely collected data, did not show a significant emerging/increasing female excess. For most physical morbidity measures reviewed, the evidence broadly points towards an emerging/increasing female excess during the transition to adolescence, although results varied by morbidity measure and study design, and suggest that this may occur at a younger age than previously thought.

Effort–reward imbalance in the school setting: Associations with somatic pain and self-rated health

“…gender differences were found in that girls reported higher extrinsic effort and higher overcommitment than boys. In line with previous research [1,2,23,24], girls reported worse overall and somatic health than boys. For self-rated health the most important gender difference was that a substantially greater share of boys than girls reported 'Very good' health.…”

Examining Body Satisfaction and Emotional–Social Intelligence among School Children: Educational Implications

“…In order to awaken interest in these kinds of programs and make them effective, they must be adapted to the demands of contemporary society. Therefore, the use of new technologies could be applied, such as the creation of educational blogs in which students participate actively or the use of mobile applications for adequate consumption of food and for the practice of physical activity [37,38]. It is also interesting for participants to experience all this in workshops designed by specialists in each of the affected areas, so that prevention is reinforced with active, cooperative, and collaborative learning.…”

Effects of workplace, family and cultural influences on low back pain: What opportunities exist to address social factors in general consultations?

“…Although social disadvantage is not frequently cited as a social factor in LBP disability, social and economic disadvantage is certainly associated with poorer outcomes in other health domains [57,58]. Longitudinal studies of LBP prognosis typically include demographic assessments of age, gender, income, education and race/ethnicity, and these variables might be considered as a general metric of social standing.…”